Postoperative right heart function detection and evaluation device for heart transplantation

Abstract

The invention discloses a device for detecting and evaluating a right heart function after a heart transplantation operation. Relates to the technical field of medical instruments. The supporting assembly is arranged on the movable base in a rotatable mode; the cardiac ultrasound equipment is arranged on the supporting assembly; and the blood pressure and hemodynamics detection equipment is also arranged on the supporting assembly, and the blood pressure and hemodynamics detection equipment is arranged opposite to the cardiac ultrasound equipment. According to the detection device, ultrasonic detection can be conducted on the right heart function after the heart transplantation operation, meanwhile, pulmonary artery pressure and hemodynamic detection can be conducted, whether the structure and the function of the heart are abnormal or not is known by observing the right heart state after the transplantation operation, the heart function is closely detected after the operation, and the prognosis of a patient is remarkably improved.

Description

Technical Field

[0001] The present invention relates to the technical field of medical devices, and more particularly to a device for detecting and evaluating right ventricular function after heart transplantation. Background Art

[0002] Right ventricular dysfunction after heart transplantation is a common complication, affecting approximately 50% of heart transplant patients, and 19% of early postoperative deaths are due to acute right ventricular failure. Possible causes of right ventricular dysfunction include elevated preoperative pulmonary artery pressure and pulmonary vascular resistance, which increase the risk of perioperative mortality and postoperative right ventricular failure, infection, and arrhythmias.

[0003] Clinical manifestations of right ventricular dysfunction after heart transplantation include: increased central venous pressure, which may lead to a decrease in blood pressure, especially when the right heart is severely overloaded. Various types of arrhythmias may occur, with atrial fibrillation, atrial flutter, and supraventricular tachycardia being the predominant manifestations in mild right ventricular failure; and malignant ventricular arrhythmias in severe right ventricular failure. Decreased or anuria may also occur. Hypoxemia and pleural effusions may also occur. Post-extubation, patients may experience dyspnea and mental symptoms such as irritability, restlessness, and agitation.

[0004] Measures to prevent right ventricular dysfunction include preoperative assessment and management of pulmonary hypertension and pulmonary vascular resistance. Close monitoring of cardiac function during and after surgery is essential. Right ventricular dysfunction after heart transplantation is a complex problem requiring multidisciplinary team management. Prompt identification and appropriate treatment can significantly improve patient outcomes.

[0005] Therefore, how to provide a device for detecting and evaluating right ventricular function after heart transplantation that can perform ultrasonic detection of right ventricular function after heart transplantation, and can also detect pulmonary artery pressure and perform hemodynamic detection is a problem that technicians in this field urgently need to solve. Summary of the Invention

[0006] In view of this, the present invention provides a device for detecting and evaluating right ventricular function after heart transplantation, which aims to solve one of the problems in the above-mentioned background technology. It can perform ultrasonic detection of right ventricular function after heart transplantation, and can also detect pulmonary artery pressure and perform hemodynamic detection.

[0007] In order to achieve the above object, the present invention adopts the following technical solutions:

[0008] A device for detecting and evaluating right ventricular function after heart transplantation, comprising:

[0009] Mobile base;

[0010] a support assembly rotatably disposed on the mobile base;

[0011] a cardiac ultrasound device, the cardiac ultrasound device being disposed on the support assembly;

[0012] A blood pressure and hemodynamics detection device is also arranged on the support assembly, and the blood pressure and hemodynamics detection device is arranged opposite to the cardiac ultrasound device.

[0013] Furthermore, the support assembly includes a lifting column and a support platform, the lifting column is arranged on the mobile base, the support platform is rotatably arranged on the top of the lifting column, and a handle is provided on the support platform.

[0014] Furthermore, the cardiac ultrasound device includes a frame, a display screen and a vertical rod. The frame is arranged on the supporting platform, the vertical rod is provided on the frame, and the display screen is rotatably arranged on the vertical rod.

[0015] Furthermore, the blood pressure and hemodynamic detection equipment includes a screen, a host and a catheter. The host is arranged on the side of the support platform away from the cardiac ultrasound, the screen is arranged on the host, and multiple catheters are provided. Multiple catheters are connected to the screen, and the catheters include venous catheters and arterial catheters.

[0016] Furthermore, storage boxes are provided on both sides of the mobile base, and both storage boxes can be slidably arranged on both sides of the mobile base. Both storage boxes are arranged below the cardiac ultrasound equipment and the blood pressure and hemodynamics detection equipment, and each storage box is provided with auxiliary equipment.

[0017] Furthermore, a buffer seat is provided at the connection position between the lifting column and the movable base.

[0018] As can be seen from the above technical solutions, compared with the prior art, the present invention provides a device for detecting and evaluating right ventricular function after heart transplantation, which can adjust the height and angle according to the doctor's working position by setting a support component;

[0019] By setting up cardiac ultrasound equipment, it is possible to perform ultrasound testing on the right heart function after heart transplantation, analyze the right heart function from the echocardiogram, and collect the interventricular septal ultrasound image of the left ventricular short axis of the subject in real time. Using echocardiography as a detection method, it is also possible to indirectly assess the pulmonary artery pressure and analyze the changes in right heart function after transplantation;

[0020] By setting up blood pressure and hemodynamic testing equipment, it is possible to conveniently test blood pressure and conduct hemodynamic testing, analyze right heart function from the perspective of hemodynamics, and conduct hemodynamic testing based on the patient's overall condition, meeting the needs of different stages of clinical hemodynamic management, and greatly improving the clinical understanding of the disease and the accuracy of treatment;

[0021] This device can be used to observe the status of the right heart after transplantation, understand whether there are abnormalities in the structure and function of the heart, closely monitor heart function after surgery, detect and identify in a timely manner, and provide appropriate treatment, significantly improving the patient's prognosis. BRIEF DESCRIPTION OF THE DRAWINGS

[0022] In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the following briefly introduces the drawings required for use in the embodiments or the description of the prior art. Obviously, the drawings described below are merely embodiments of the present invention. For ordinary technicians in this field, other drawings can be obtained based on the provided drawings without paying any creative work.

[0023] Figure 1 This is a schematic structural diagram of the device for detecting and evaluating right ventricular function after heart transplantation provided by the present invention;

[0024] Figure 2 A schematic diagram of the structure of the device for detecting and evaluating right ventricular function after heart transplantation provided by the present invention (from another perspective);

[0025] Figure 3 A schematic structural diagram of the support assembly and the mobile base provided by the present invention;

[0026] Figure 4 A schematic structural diagram of the portable cardiac ultrasound device provided by the present invention;

[0027] Figure 5 A cardiogenic shock classification diagram provided by the present invention;

[0028] Figure 6 This is the portal hypertension assessment diagram provided by the present invention.

[0029] Among them: 1 is a mobile base; 2 is a lifting column; 3 is a supporting platform; 4 is a handle; 5 is a rack; 6 is a display screen; 7 is a vertical rod; 8 is a screen; 9 is a host; 10 is a catheter; 11 is a storage box; 12 is an auxiliary device; 13 is a buffer seat. DETAILED DESCRIPTION

[0030] The following will clearly and completely describe the technical solutions in the embodiments of the present invention in conjunction with the accompanying drawings. Obviously, the described embodiments are only part of the embodiments of the present invention, not all of the embodiments. Based on the embodiments of the present invention, all other embodiments obtained by ordinary technicians in this field without making creative efforts are within the scope of protection of the present invention.

[0031] See also Figure 1-6 The embodiment of the present invention discloses a device for detecting and evaluating right ventricular function after heart transplantation, comprising:

[0032] Mobile base 1; it is easy to move by using the mobile base 1;

[0033] The support assembly is rotatably arranged on the mobile base 1, which is convenient for rotation according to specific circumstances and has greater applicability;

[0034] A cardiac ultrasound device is mounted on the support assembly and is capable of ultrasonically detecting right ventricular function after heart transplantation, analyzing right ventricular function through echocardiography, and acquiring real-time ultrasound images of the left ventricular short axis and septum of the subject. Using echocardiography as a detection method, it can also indirectly assess pulmonary artery pressure and analyze changes in right ventricular function after transplantation.

[0035] Blood pressure and hemodynamic testing equipment. The blood pressure and hemodynamic testing equipment is also arranged on the supporting assembly, and the blood pressure and hemodynamic testing equipment is arranged opposite to the cardiac ultrasound equipment; it can conveniently detect blood pressure and conduct hemodynamic testing, analyze the right heart function from the hemodynamics, and conduct hemodynamic testing based on the patient's overall condition, meet the needs of different stages of clinical hemodynamic management, and greatly improve the clinical understanding of the disease and the accuracy of treatment.

[0036] In this embodiment, the support assembly includes a lifting column 2 and a support platform 3. The lifting column 2 is set on the mobile base 1, and the support platform 3 is rotatably set on the top of the lifting column 2. A handle 4 is provided on the support platform 3; it can be adjusted in height and angle, which is convenient for adjusting the height and angle according to the doctor's working position and is convenient for observation and use.

[0037] In this embodiment, the cardiac ultrasound equipment includes a frame 5, a display screen 6 and a vertical rod 7. The frame 5 is set on the support platform 3, and the vertical rod 7 is provided on the frame 5. The display screen 6 is rotatably set on the vertical rod 7; by setting the display screen 6 rotatably on the vertical rod 7, the direction of the display screen 6 can be adjusted according to specific circumstances, making it more convenient for doctors to observe and use.

[0038] In this embodiment, the blood pressure and hemodynamic detection equipment includes a screen 8, a host 9 and a catheter 10. The host 9 is arranged on the side of the support platform 3 away from the cardiac ultrasound, the screen 8 is arranged on the host 9, and multiple catheters 10 are provided. The multiple catheters 10 are all connected to the screen 8. The catheters 10 include a venous catheter 10 and an arterial catheter 10; the venous catheter 10 and the arterial catheter 10 are placed into the patient's body, and the venous catheter 10 can be connected to the pulmonary artery catheter to obtain cardiac output, systemic circulation resistance, pulmonary resistance, etc., so as to achieve the purpose of jointly applying multiple data to detect hemodynamic changes.

[0039] In this embodiment, storage boxes 11 are provided on both sides of the mobile base 1. The two storage boxes 11 can be slidably set on both sides of the mobile base 1. The two storage boxes 11 are both set below the cardiac ultrasound equipment and the blood pressure and hemodynamics detection equipment. Each storage box 11 is provided with an auxiliary device 12; by setting the storage boxes 11, a composite device for detecting cardiac function is formed; the auxiliary devices 12 include infusion bags, puncture bags, syringes, saline, iodine tincture, etc.

[0040] In this embodiment, a buffer seat 13 is provided at the connection position between the lifting column 2 and the movable base 1; when the support platform 3 moves through the lifting column 2, the buffer seat 13 improves the stability of the lifting column 2, reduces the shaking of the support platform 3, and is more stable when the height is adjusted according to the doctor's working position.

[0041] In addition, in this embodiment, as shown in the attached Figure 4 As shown, the cardiac ultrasound device can be configured as a portable ultrasound instrument. The portable ultrasound instrument is detachably mounted on the support platform 3. The portable ultrasound instrument can be transferred and placed at the patient's bedside or other locations for greater convenience.

[0042] Specific usage process

[0043] Move the mobile base 1 to the working position to determine the specific items that need to be tested;

[0044] When it is necessary to perform ultrasonic testing on the right heart function after heart transplantation, the support platform 3 is rotated to make the cardiac ultrasound device face the patient, and the patient is subjected to ultrasonic testing. The right heart function is analyzed from the echocardiogram, and the ventricular septum ultrasound image of the left ventricular short axis of the subject is collected in real time. Using echocardiography as a detection means, the pulmonary artery pressure can be indirectly evaluated, and the changes in right heart function after transplantation can be analyzed. When performing ultrasonic testing, the direction of the display screen 6 can be adjusted according to the specific situation, making it more convenient for doctors to observe and use. The main evaluation indicators of right heart function evaluated by echocardiography include tricuspid annular systolic displacement (TAPSE), tissue Doppler tricuspid annular systolic velocity Sa, right ventricular myocardial work index (RIMP) or Tei index, right ventricular area change (FAC), three-dimensional right ventricular ejection fraction, isovolumetric contraction myocardial acceleration, right ventricular longitudinal myocardial strain and other indicators.

[0045] When it is necessary to perform blood pressure and hemodynamic testing on right heart function after heart transplantation, the support platform 3 is rotated so that the blood pressure and hemodynamic testing equipment is facing the patient, a pulmonary artery catheter is inserted, and the catheter is connected to the pressure sensor to measure cardiac output and perform hemodynamic monitoring. The right heart function is analyzed from the hemodynamic perspective. Performing hemodynamic testing can take the patient's overall condition into consideration, meet the needs of different stages of clinical hemodynamic management, and greatly improve the clinical understanding of the condition and the accuracy of treatment.

[0046] The aforementioned data detected by ultrasound and hemodynamics are integrated, including the background classification of right ventricular dysfunction, and then the data is displayed, and an overall judgment is made on the integrated data; the degree of right ventricular dysfunction after heart transplantation is comprehensively assessed, and targeted treatment is given.

[0047] Adjust the height of the support platform 3 by using the lifting column 2 as needed;

[0048] This device can be used to observe the status of the right heart after transplantation, understand whether there are abnormalities in the structure and function of the heart, closely monitor heart function after surgery, detect and identify in a timely manner, and provide appropriate treatment, significantly improving the patient's prognosis.

[0049] Specific hemodynamic monitoring content:

[0050] 1. Pulmonary artery pressure (PAP) is one of the most important parameters measured by a pulmonary artery catheter. It not only provides the pressure status of the pulmonary circulation, but also indirectly infers the left ventricular end-diastolic pressure based on its diastolic pressure. It is an essential parameter for calculating pulmonary circulation resistance. Therefore, most current monitors can monitor it continuously for dynamic observation. Normal values ​​are systolic pressure <30 mmHg (4 kPa), diastolic pressure <12 mmHg (1.6 kPa), and mean pressure <16 mmHg (2.13 kPa).

[0051] 2. Right atrial pressure (RAP) can replace central venous pressure and is valuable for estimating right ventricular function and calculating systemic circulation resistance. Because pulmonary artery pressure is also measured, it is no longer simply used as an indicator of blood volume adequacy under pulmonary artery catheter monitoring conditions. It is generally measured intermittently, and can also be monitored continuously if a separate transducer is available. The normal value is a mean pressure of 2 to 6 mmHg, and an increase of more than 10 mmHg is considered elevated. It can drop to -7 mmHg during deep inspiration and rise to +8 mmHg during deep exhalation. Changes in right atrial pressure depend on blood volume, venous vascular tension and right ventricular function. RAP increases in right-sided heart failure, tricuspid valve disease, restrictive cardiomyopathy, cardiac tamponade and increased right ventricular pressure. A decrease is seen in insufficient circulating blood volume.

[0052] 3. Pulmonary artery wedge pressure (PAWP), also known as pulmonary wedge pressure, is a unique feature of the pulmonary artery catheter. In the absence of pulmonary vein and mitral valve obstruction, it can accurately reflect left ventricular end-diastolic pressure. Therefore, it is of great value in determining cardiac function, blood volume adequacy, and guiding treatment. It is also one of the parameters for calculating pulmonary circulation resistance. Measurement of PAWP requires the use of an air bag to block blood flow in a specific pulmonary artery branch, so it can only be measured intermittently. The normal value is a mean pressure of 5-12 mmHg (0.67-1.6 kPa).

[0053] 4. Right ventricular pressure (RVP) is mostly used for diagnostic purposes, such as determining whether there is right ventricular myocardial infarction, whether there is stenosis of the pulmonary valve or outflow tract, etc.; the normal value is systolic pressure <30mmHg (4kPa) and end-diastolic pressure <8mmHg (1.07kPa).

[0054] 5. Cardiac output (CO) This is also a unique function of the pulmonary artery catheter, which uses the thermodilution method (also known as the thermodilution method), which is currently the simplest and relatively accurate method. The principle is to inject a certain amount of cold water into the upper right atrium through the pulmonary artery catheter for a certain period of time. This cold water mixes with the blood in the heart, causing the temperature to drop. The cooled blood then flows to the pulmonary artery, where the temperature change is monitored by a thermistor. The cold blood is then removed and the blood temperature gradually returns to normal. The thermodilution curve is recorded based on the temperature changes sensed by the thermistor in the pulmonary artery, and CO is calculated using a formula. In adults, 5-10 ml of 5% GS or 0.9% NS at 0-5°C is usually rapidly injected into the upper right atrium through the proximal hole. The injection can be repeated once every 1 minute for 3 consecutive times, and the average value is calculated. The normal value is (6.0±2.0) L / min.

[0055] The above parameters are all obtained by direct measurement; if combined with the patient's height, weight, arterial pressure and other parameters, the following parameters can also be calculated: cardiac index (CI), systemic circulatory resistance (SVR), systemic circulatory resistance index (SVRI), pulmonary circulatory resistance (PVR), pulmonary circulatory resistance index (PVRI), stroke volume (SV), stroke volume index (SVI), left ventricular work (LCW), left ventricular work index (LCWI), right ventricular work (RCW), right ventricular work index (RCWI), left ventricular stroke work (LSVW), left ventricular stroke work index (LSVWI), right ventricular stroke work (RSVW), right ventricular stroke work index (RSVWI), etc.

[0056] The detection and analysis of hemodynamic data are integral aspects of the care of patients with heart failure;

[0057] Right heart catheterization should be performed in patients with cardiogenic shock, suspected or confirmed heart failure that is refractory to treatment, or those undergoing further surgical evaluation.

[0058] More data are needed to demonstrate the benefits of right heart catheterization in heart failure, including improved survival and prevention of hospital readmission and peripheral organ damage.

[0059] Cardiogenic shock (CS) refers to severe myocardial dysfunction leading to reduced cardiac output (CO) and systemic hypoperfusion, accompanied by tissue ischemia and / or hematometabolism disorders. To help identify and assess the risk of patients with cardiogenic shock (CS), the Society for Cardiovascular Angiography and Interventions (SCAI) published an updated consensus statement in 2019, which classified cardiogenic shock into five stages. Table 1 shows the classification of cardiogenic shock stages. It can be seen that hemodynamic data and biomarkers obtained by RHC play an important role in this stage classification.

[0060] Table 1: Right heart indexes and calculation methods

[0061]

[0062]

[0063] As heart failure progresses, the liver may experience varying degrees of functional failure due to the primary disease, hypoperfusion, increased venous pressure, and other factors. Accurate assessment of the cause of liver dysfunction can be used to guide the management of right ventricular dysfunction after heart transplantation. Table 2 details the key points and analysis of liver hemodynamic assessment.

[0064] The various embodiments in this specification are described in a progressive manner, with each embodiment focusing on the differences from other embodiments. Reference can be made to the common and similar parts between the various embodiments. For the devices disclosed in the embodiments, since they correspond to the methods disclosed in the embodiments, the description is relatively simple, and the relevant parts can be referred to the method description.

[0065] The above description of the disclosed embodiments is intended to enable one skilled in the art to implement or use the present invention. Various modifications to these embodiments will be readily apparent to one skilled in the art, and the general principles defined herein may be implemented in other embodiments without departing from the spirit or scope of the present invention. Therefore, the present invention is not limited to the embodiments shown herein but is intended to conform to the widest scope consistent with the principles and novel features disclosed herein.

Claims

1. A device for detecting and evaluating right ventricular function after heart transplantation, characterized in that: include: Mobile base; a support assembly rotatably disposed on the mobile base; a cardiac ultrasound device, the cardiac ultrasound device being disposed on the support assembly; A blood pressure and hemodynamics detection device is also arranged on the support assembly, and the blood pressure and hemodynamics detection device is arranged opposite to the cardiac ultrasound device.

2. The device for detecting and evaluating right ventricular function after heart transplantation according to claim 1, characterized in that: The support assembly includes a lifting column and a support platform. The lifting column is arranged on the mobile base. The support platform is rotatably arranged on the top of the lifting column. A handle is provided on the support platform.

3. The device for detecting and evaluating right ventricular function after heart transplantation according to claim 2, characterized in that: The cardiac ultrasound device comprises a frame, a display screen and a vertical rod. The frame is arranged on the supporting platform, the vertical rod is provided on the frame, and the display screen is rotatably arranged on the vertical rod.

4. The device for detecting and evaluating right ventricular function after heart transplantation according to claim 2, wherein: The blood pressure and hemodynamics detection equipment includes a screen, a host and a catheter. The host is arranged on a side of the support platform away from the cardiac ultrasound. The screen is arranged on the host. Multiple catheters are provided, and the multiple catheters are connected to the screen. The catheters include venous catheters and arterial catheters.

5. The device for detecting and evaluating right ventricular function after heart transplantation according to claim 4, characterized in that: Storage boxes are provided on both sides of the mobile base. Both storage boxes can be slidably arranged on both sides of the mobile base. Both storage boxes are arranged below the cardiac ultrasound equipment and the blood pressure and hemodynamics detection equipment. Each storage box is equipped with auxiliary equipment.

6. The device for detecting and evaluating right ventricular function after heart transplantation according to claim 2, characterized in that: A buffer seat is provided at the connection position between the lifting column and the movable base.

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